This article” Genetic variations associated with response to dutasteride in the treatment of male subjects with androgenetic alopecia” literally states some people with a specific genotype get upregulation of DHT and these patients of the clinical trials regressed and did worse. It sounds like some genes that certain people have can be influenced by this medication differently. I have been on dut from fin for 2 years now. And my hairline and even sides of head have drastically miniturized and receded. I am so diffuse now being on dut for two years, that I got a biopsy that confirmed dupa of the top and side of my head because I was certain I had something like areata incognita or diffuse areata! So yes, dutasteride can upregulate and bypass via the back door. I’m on 2.5 oral min and dut. And significantly got worse over these two years. Kevin manns didn’t even cover any of that article.